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Michael P. Steinmetz Thomas E. Mroz Ajit Krishnaney Michael Modic 《The spine journal》2009,9(12):967-971
BackgroundIn today's health-care environment, operational efficiency is intrinsic to balancing the need for increased productivity driven by rising costs and potentially decreasing reimbursement. Other operational factors kept constant, decreasing the time for a procedure can be viewed as one marker for increased efficiency.PurposeTo prospectively evaluate the time and operating room efficiency differences between the two methods for intraoperative level localization.Stydy designProspective nonrandomized study.Patient sampleProspective consecutive patients undergoing a single-level anterior cervical discectomy and fusion (ACDF) with plate and allograft.Outcomes measuresTime for performance and interpretation of intraoperative localization radiograph.MethodsThis is a prospective nonrandomized study of patients treated consecutively with a single-level ACDF with allograft and plating. All the patients underwent a conventional approach to the cervical spine. After exposure, a spinal needle was placed in the exposed intervertebral disc and a radiography was performed. Either a conventional or a digital radiography was used in each case.ResultsEighteen patients were enrolled in this study. Ten patients underwent localization with conventional radiography, whereas eight patients underwent localization with digital imaging. The mean time for conventional radiography was 823 seconds (standard deviation [SD], 159), and for digital, it was 100 seconds (SD, 34; p<.001).ConclusionsCurrent technology provides options for level localization. Digital imaging provides equally accurate information as conventional radiography in a significantly reduced amount of time. Image quality, ease or archival, and manipulation provided by digital radiography are superior to those by provided fluoroscopy. Keeping operational factors constant, decreasing the time for a procedure, and increasing the efficiency of the environment may be viewed as a surrogate for improving the cost basis for a procedure. 相似文献
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E MOLKE JENSEN K. A. THIESSEN AA. CHRISTENSEN 《Acta anaesthesiologica Scandinavica》1986,30(2):109-110
The effect of 4 mg oral naloxone on preoperative gastric volume and pH of gastric aspirate was studied in a double-blind, randomized study. Twenty patients received 10 ml of naloxone (4 mg) mixed with 10 ml of orange juice, and 20 patients received 10 ml of isotonic saline mixed with 10 ml of orange juice, 2 h before surgery. Gastric content was obtained immediately after intubation of the trachea. No significant difference in gastric volume and pH of gastric aspirate was found between the two groups. It is concluded that naloxone does not affect gastric emptying and gastric acid secretion to a degree great enough to protect against aspiration of gastric contents into the lungs. 相似文献
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Smoking and female infertility: a systematic review and meta-analysis 总被引:11,自引:10,他引:11
The high prevalence of smoking among women in their reproductive years
continues to be a matter of concern. The negative effects of smoking on
general health are well known, but smoking may also affect fertility. The
objective of the present study was to perform a systematic review of the
literature to determine whether there is an association between smoking and
risk of infertility in women of reproductive age, and to assess the size of
this effect. In the 12 studies used for this meta- analysis, the overall
value of the odds ratio (OR) for risk of infertility in women smokers
versus non-smokers was 1.60 [95% confidence interval (CI) 1.34-1.91].
Studies of subfertile women undergoing in-vitro fertilization (IVF)
treatment also show a reduction in fecundity among women smokers. A
meta-analysis of nine studies found an OR of 0.66 (95% CI 0.49-0.88) for
pregnancies per number of IVF- treated cycles in smokers versus
non-smokers. Despite the potential limitations of meta-analyses of
observational studies, the evidence presented in this review is compelling
because of the consistency of effect across different study designs, sample
size and types of outcome. However, continued reassurance is needed that
the calculated overall effect is not in fact due to confounding variables.
相似文献